title: A comparison of genotype and markers of disease severity of chronic hepatitis C in patients with and without end-stage renal disease.
abstract: BACKGROUND
  This study was conducted to compare the genotype and markers of disease severity of chronic hepatitis C (CHC), namely viral load, alanine transaminase (ALT) levels and histopathological findings on liver biopsy, in patients with and without end-stage renal disease (ESRD).
  
  
  METHODS
  This was a cross-sectional retrospective comparative study that included ESRD patients on haemodialysis and non-ESRD patients with CHC who underwent liver biopsy between January 2004 and December 2006. Blood tests for viral load (VL) (hepatitis C virus, ribonucleic acid, polymerase chain reaction), genotyping and ALT were administered. VL was grouped into low (less than 5 log10) and high (more than or equal to 5 log10) VL, genotype into G1 and 2, 3, 4, and ALT into normal and elevated ALT. Necroinflammatory activity was grouped into mild (G0-6) and moderate/severe (G7-18) activity, and fibrosis into mild (S0-2) and moderate/severe (S3-6) fibrosis. These variables were compared between the two groups.
  
  
  RESULTS
  Genotype 1 was significantly higher in ESRD patients than in non-ESRD patients, in whom genotypes 2, 3 and 4 were higher. Although the proportion of patients with high VL was greater and the duration of CHC was longer in the ESRD group, the ALT levels were lower and the histopathological grading of necroinflammatory activity and stages of fibrosis were less severe in ESRD compared to non-ESRD patients.
  
  
  CONCLUSIONS
  The lower levels of ALT observed in CHC patients with ESRD translate to histopathological benefits.
authors.affiliation: Internal Medicine and Gastroenterology, Hospital Sultanah Bahiyah, KM6, Jalan Langgar, Alor Star 05460, Malaysia. radzi@crc.gov.my
authors.forename: M R
authors.initials: MR
authors.lastname: Hassan
authors.forename: N R N
authors.initials: NR
authors.lastname: Mustapha
authors.forename: F M
authors.initials: FM
authors.lastname: Zawawi
authors.forename: B S P
authors.initials: BS
authors.lastname: Earnest
authors.forename: K
authors.initials: K
authors.lastname: Voralu
authors.forename: S P
authors.initials: SP
authors.lastname: Pani
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D001706:Biopsy; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006515:Hepatitis B virus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000097:blood / Q000175:diagnosis* / Q000235:genetics; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D008099:Liver / Q000378:metabolism / Q000473:pathology*; D008297:Male; D016133:Polymerase Chain Reaction; D011379:Prognosis; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D012367:RNA, Viral; D000410:Alanine Transaminase